CLINICAL CORE SUMMARY The Clinical Core is the central working component of the Alzheimer s Disease Research Center, under the overall direction of the Administration Core. It is a shared resource for the entire ADRC, interacting closely with Outreach, Recruitment, & Education Core (recruitment and training), Data Management and Statistical Core (data storage, retrieval, and management), Neuropathology Core (arranging brain autopsy, and providing related clinical data), and Genetics Core (providing DNA samples for genetic analyses, and clinical data). The primary activities of the core are to recruit participants, and perform detailed evaluations of the participants, obtaining data and resources that can be used by the other Cores, Projects, and Pilot Projects, as well as nationally and internationally through collaborations and provision of data to the National Alzheimer s Coordinating Center (NACC). The Core at Columbia university proposes to continue its 24 years of recruitment of well-followed, well-characterized research participants of diverse ethnoracial background including about 40% under-represented groups: currently we have enrolled >5,700 individuals, nearly 1600 of which are in the NACC Uniform Data Set (UDS), and 40% are minorities -- including 20% Hispanic and 11% African American enrollees. During the past 8 years of UDS data collection, the Core has contributed to the UDS more participants (1596), and has more active participants (904), than any one of the other 26 NIA-Alzheimer centers. The Clinical Core emphasis is on recruitment of normal controls and persons with mild impairment, allowing greater research into normal aging, and the transition from normal aging to mild cognitive impairment (MCI) and dementia. The Core also continues to recruit participants with less usual dementias, to promote better neuropathological and molecular understanding of the mixed and atypical dementia disorders, including Dementia with Lewy Bodies, Frontotemporal Dementia, Creutzfeldt-Jakob Disease, and Vascular Cognitive Impairment and Dementia. Evaluations include detailed medical interviews and examinations, neurological examinations, NACC-UDS and Columbia-specific neuropsychological testing, blood samples for plasma and DNA preparation and storage by the Genetics Core, increasing numbers of CSF specimens and neuroimaging data including MRI, SPECT, and PET scans, and ultimately brain neuropathological specimens for the over 50% of our participants currently consenting to brain autopsy. The Core coordinates closely with Administrative, Data, Education, Genetics, and Neuropathology Cores. Participants are informed of other trials and projects, and encouraged to participate in these important imaging, instrument, drug study, and other trials. The Clinical Core provides training to students, residents, fellows, and investigators. Participant data, images, and biological specimens, including plasma, DNA, CSF, brain tissue are shared with ADRC, other Columbia, and extramural investigators to improve diagnosis, understanding and treatment of aging and dementia, promoting basic and translational research at Columbia, in the New York area, and nationwide. .